Thromboangiitis obliterans is a non-atherosclerotic inflammatory disease that affects small and medium-sized arteries. It predominantly affects young male smokers. The presentation is with pain in the lower extremities due to arterial insufficiency. Diagnosis involves excluding other causes through testing and showing features of segmental stenosis and occlusions on angiography. Treatment involves complete smoking cessation, medications to improve blood flow, and surgery in severe cases. Prognosis depends on patient adherence to avoiding tobacco.
Buerger's disease (thromboangiitis obliterans) is a rare disease of the arteries and veins in the arms and legs. In Buerger's disease, your blood vessels become inflamed, swell and can become blocked with blood clots (thrombi)
introduction, causes, risk factors, symptoms, examination, investigations and management of peripheral arterial disease.
how to assess the patient and what will be the complications of PAD, physiotherapy treatment for PAD
Buerger’s disease, also called thromboangiitis obliterans, is an inflammation of small- and medium-sized blood vessels. Although any artery can be affected, it usually presents with blockages of the arteries to the feet and hands, leading to pain and tissue damage.
The disease is found worldwide and can affect people of any race and age group. However, it mainly affects Asian and Middle Eastern men between the ages of 40 and 45 who heavily use, or have heavily used, tobacco products, including chewing tobacco.
There isn’t a cure for Buerger’s disease. However, the single-most important factor in improving symptoms and preventing its progression is quitting smoking.
In rare cases, the pain may be so severe that a surgical procedure called a sympathectomy may be performed to eliminate the pain.
Buerger's disease (thromboangiitis obliterans) is a rare disease of the arteries and veins in the arms and legs. In Buerger's disease, your blood vessels become inflamed, swell and can become blocked with blood clots (thrombi)
introduction, causes, risk factors, symptoms, examination, investigations and management of peripheral arterial disease.
how to assess the patient and what will be the complications of PAD, physiotherapy treatment for PAD
Buerger’s disease, also called thromboangiitis obliterans, is an inflammation of small- and medium-sized blood vessels. Although any artery can be affected, it usually presents with blockages of the arteries to the feet and hands, leading to pain and tissue damage.
The disease is found worldwide and can affect people of any race and age group. However, it mainly affects Asian and Middle Eastern men between the ages of 40 and 45 who heavily use, or have heavily used, tobacco products, including chewing tobacco.
There isn’t a cure for Buerger’s disease. However, the single-most important factor in improving symptoms and preventing its progression is quitting smoking.
In rare cases, the pain may be so severe that a surgical procedure called a sympathectomy may be performed to eliminate the pain.
PERIPHERAL ARTERIAL DISEASES- INTRODUCTION- Limb Ischemia
Dear Viewers,
Greetings from “Surgical Educator”
Today I am uploading an introductory video on “Peripheral Arterial Diseases”. In this video I have discussed the surgical anatomy, modes of presentation, symptoms, signs, investigations and a diagnostic algorithm of Peripheral Arterial Diseases. In the subsequent three videos I will discuss about chronic lower limb ischemia, acute lower limb ischemia and upper limb ischemia. I hope you will enjoy these series of teaching videos. You can watch these videos in the following links:
surgicaleducator.blogspot.com
youtube/c/surgicaleducator
Thank you for watching the video.
PERIPHERAL ARTERIAL DISEASES- INTRODUCTION- Limb Ischemia
Dear Viewers,
Greetings from “Surgical Educator”
Today I am uploading an introductory video on “Peripheral Arterial Diseases”. In this video I have discussed the surgical anatomy, modes of presentation, symptoms, signs, investigations and a diagnostic algorithm of Peripheral Arterial Diseases. In the subsequent three videos I will discuss about chronic lower limb ischemia, acute lower limb ischemia and upper limb ischemia. I hope you will enjoy these series of teaching videos. You can watch these videos in the following links:
surgicaleducator.blogspot.com
youtube/c/surgicaleducator
Thank you for watching the video.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
5. Thromboangiitis Obliterans is an inflammatory obliterative
nonatheromatous vascular disease that affects the small and
medium-sized arteries, veins, and nerves.
Definition
6. While it is only associated with mild
inflammatory changes, the presence of
inflammation means that this disease is
considered to be a vasculitis.
Is it vasculitis?
7. Thromboangiitis Obliterans is predominantly a disease of young men, most
commonly affecting individuals between the ages of 18 and 50 years; and
men are more commonly affected than women. The disease is also more
common in the Middleand Far East than in North America and Western
Europe.
There is a strong association with tobacco exposure, although thromboangiitis
obliterans has been reported even in individuals who only smoke small
amounts, and it has also been seen in pipe smokers,marijuana users, and
tobacco chewers.
Epidemiology
9. The only risk factor consistently reported is smoking.
Cigar and pipe smoking;
Habitual home-made cigarette “bidi” smoking in India, Bangladesh.
“kawung” smoking in Indonesia;
Chewed “miang” (steamed tea leaves) or “khiyo” (the home-made raw
t tobacco in handrolled banana leaves) smoking in Thailand,
Smokeless tobacco and marijuana.
Lower socioeconomic status, poor oral hygiene, nutritional deficits, history
o of viral or fungal infection, cold injury, abuse of sympathomimetic drugs,
Arsenic intoxication are reported as other possible risk factors.
Cocaine, amphetamines, and cannabis addiction.
Risk factors
10. The etiology of Thromboangiitis Obliterans is unknown;
Closly associated with
1. Use of tobacco in any form is beyond any debate.
2. Genetic predisposition,
3. Immunemediated mechanisms,
4. Hypercoagulable states,
5. Endothelial dysfunction,
6. Oral infection-inflammatory pathway
Etiology
11. The specific pathologic mechanisms in
TAO are still unknown.
BD is characterized by segmental
inflammatory cellinfiltration of the vessel
wall and arterial or venous thrombotic
occlusions.
Hypercellularthrombus formation and
preserved architecture of vessel wallsis
wellestablished in TAO
Pathology
Typical subacute
thrombotic occlusion
of the right digital
artery
12. The initial manifestation of TO is lower extremity claudication.
sometimes progresses to digital ischemia.
Pedal, instep claudication is also a very specific symptom.
Gangrene,ulceration, or rest pain is the presenting complaint in
one-third of patients;
Nail trimming or pressure from tight shoes.
Superficial thrombophlebitis and Raynaud’s syndrome are also
described
Clinical Presentation
13. TO is a diagnosis of exclusion
Prothrombotic states, diabetes, and other autoimmune diseases; especially scleroderma
should be excluded before attributingdigital gangrene to TO.
Echocardiogram to rule out infectious endocarditis .
Arteriogram to rule out atherosclerosis.
Arteriographic features
1.Bilateral focal segmental stenosis
2.Occlusion with relatively normal interveningvessels.
3.Collateral developmentaround areas of occlusion lead to the appearance of
“ “tree-root,” “spiders web,” or “corkscrew”collaterals.
4.The most importantfinding is that proximal arteries are normal without evidence of
a atherosclerosis or emboli
Diagnostic Testing
14. (1) Smoking history
(2) Onset before age 50,
(3) Infrapopliteal arterial occlusive lesions,
(4) Upper limb involvement or phlebitis migrans,
(5) An absence of atherosclerotic risk factors other than smoking.
Shionoya’s
major criteria
Dx contd..
15. 1. Age less than 45 years;
2. Current (or recent) history of tobacco use;
3. The presence of distal-extremity ischemia(indicated by
claudication, pain at rest, ischemic ulcers, or gangrene)
documented by noninvasive vasculartesting;
4. Exclusion of autoimmune diseases, Hypercoagulable states, and
diabetesmellitusby laboratory tests;
5. Exclusion of a proximal source of emboli by echocardiography and
arteriography;
6. Consistent arteriographic findings in the clinically involved and
noninvolvedlimbs
Dx contd..
Olin’s criteria
16. Decreased vascular resistance may develop as a result of
increased collateral blood visualize and functionally evaluate the
corkscrew shaped collaterals.
Using continuous wave Doppler ultrasound monophasic waveform
pattern within the corkscrew shaped collaterals is also known as
Martorellsign (“snake” or“dot”sign) flow and low-resistance
cutaneous arteries
Noninvasive
testing
Color-flow Doppler studies demonstrating triphasic flow within the right (A) and left (B) anterior tibialarteries, monophasic
flow within the left dorsalis pedis artery (C), and the “dot” sign because of continuousflow within corkscrew collateralsat the
toe level (D and E).
17. (A and B) Abrupt right tibialvessel occlusion with
corkscrew collaterals(arrows) in a 34-year-old
man detected with 64-slice multidetectorcomputed
tomographicangiography
Invasive testing
Digitalsubtraction angiographyreveals left poplitealand tibial
vessel occlusions with corkscrew collaterals(arrows) proximally(A)
and distally(B) and right radialand ulnar artery involvement(C) in a
32-year-old man with a nonhealingleft toe ulceration.
18. • Involvement of small and medium-sized arteries
Digital arteries of fingers and toes
Palmar, plantar, tibial, peroneal, radial, and ulnar arteries
• Segmental occlusive lesions: diseased arterial segments interspersed with
normal-appearing segments
• More severe disease distally
• Tapering or abrupt arterial occlusions with collateralization around areas of
occlusion: described as “corkscrew collaterals,”
“spider leg” or “tree root appearance” (not pathognomonic)
• Normal proximal arteries free of atherosclerosis, aneurysms, or other sources of
emboli
Angiographic Findings in Thromboangiitis obliterans
21. Lifestyle changes
1. Complete and permanent discontinuation of
smoking in any form including passive smoking
2. Exercise Training
3. Foot, Hand, and Dental Care
Treatment